Facility Evaluation Report

Licensing Program Analyst (LPA) Erik Gonzalez Campos arrived unannounced on 10/27/2022 to conduct a required - 1 year inspection. LPA met with administrator, Mylene Dado. This inspection is focused on the infection control practices and procedures of this facility.

LPA toured building and grounds which were found to be clean and in good repair. Facility currently has two clients. Client bedrooms are located on the first floor. The amount of fresh and non-perishable food was within regulation. Fire extinguishers inspected were last charged on August 15, 2022. Toxins were locked and secured. Medications were centrally stored and locked. Carbon monoxide and smoke detectors were present and operational. Walkways were cleared and unobstructed. High touch surface areas are disinfected daily. LPA observed COVID postings at the front entrance. Visitation is preferred outside but is allowed indoors. Two clients attend a day program. Staff and clients are all fully vaccinated. Administrator has necessary Personal Protective Equipment to support a client in isolation. Clients can isolate in their own bedrooms if necessary. LPA and administrator discussed client/staff record keeping.

LPA requested the following documents be submitted to Community Care Licensing within 30 days of today's inspection:

LIC 308 Designation of Administrative Responsibility

LIC 400 Affidavit Regarding Client/Resident Cash Resources

Exit interview conducted with administrator and a copy of this report printed for the facility.